State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4414

§  4414.  Health care compliance programs. The commissioner of health,  after consultation  with  the  superintendent  of  insurance,  shall  by  regulation  establish  standards and criteria for compliance programs to  be implemented by persons providing coverage  or  coverage  and  service  pursuant to any public or governmentally-sponsored or supported plan for  health  care  coverage  or  services.  Such  regulations  shall  include  provisions for the design and implementation of programs or processes to  prevent,  detect  and  address  instances  of  fraud  and  abuse.   Such  regulations  shall take into account the nature of the entity's business  and the size of its enrolled population. The commissioner of health  and  the  superintendent  of  insurance  shall  accept programs and processes  implemented pursuant to section four hundred nine of the  insurance  law  as  satisfying  the  obligations  of  this  section  and the regulations  promulgated thereunder when such programs and processes incorporate  the  objectives contemplated by this section.

State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4414

§  4414.  Health care compliance programs. The commissioner of health,  after consultation  with  the  superintendent  of  insurance,  shall  by  regulation  establish  standards and criteria for compliance programs to  be implemented by persons providing coverage  or  coverage  and  service  pursuant to any public or governmentally-sponsored or supported plan for  health  care  coverage  or  services.  Such  regulations  shall  include  provisions for the design and implementation of programs or processes to  prevent,  detect  and  address  instances  of  fraud  and  abuse.   Such  regulations  shall take into account the nature of the entity's business  and the size of its enrolled population. The commissioner of health  and  the  superintendent  of  insurance  shall  accept programs and processes  implemented pursuant to section four hundred nine of the  insurance  law  as  satisfying  the  obligations  of  this  section  and the regulations  promulgated thereunder when such programs and processes incorporate  the  objectives contemplated by this section.

State Codes and Statutes

State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4414

§  4414.  Health care compliance programs. The commissioner of health,  after consultation  with  the  superintendent  of  insurance,  shall  by  regulation  establish  standards and criteria for compliance programs to  be implemented by persons providing coverage  or  coverage  and  service  pursuant to any public or governmentally-sponsored or supported plan for  health  care  coverage  or  services.  Such  regulations  shall  include  provisions for the design and implementation of programs or processes to  prevent,  detect  and  address  instances  of  fraud  and  abuse.   Such  regulations  shall take into account the nature of the entity's business  and the size of its enrolled population. The commissioner of health  and  the  superintendent  of  insurance  shall  accept programs and processes  implemented pursuant to section four hundred nine of the  insurance  law  as  satisfying  the  obligations  of  this  section  and the regulations  promulgated thereunder when such programs and processes incorporate  the  objectives contemplated by this section.